The study analyzed 3,272 out-of-hospital cardiac arrest patients in Zhengzhou between 2017 and 2020 and found significant gender differences in their outcomes. Women comprised 27.6% of patients and were on average older than men (70.1 vs. 61.1 years). Compared to men, women had lower rates of witnessed arrest (51.2% vs. 64.0%), bystander CPR (4.8% vs. 7.3%), use of an automated external defibrillator (8.9% vs. 12.4%), and initial shockable rhythm (6% vs. 11%). Women were also less likely to have their cardiac arrest happen in a public place (13.7% vs. 26.4%). Female gender was independently associated with a significantly lower rate of spontaneous return of cardiac activity before hospital arrival. The authors recommend targeted strategies to reduce these disparities, including expanding inclusive CPR training, promoting gender-sensitive use of AEDs, and increasing community awareness of women's resuscitation.